The Good News for Medicare Beneficiaries

Three recent pieces of news out of Washington, D.C., may mean more certainty and better coverage for current and future beneficiaries of Medicare — the federal health program for people 65 and older.

No. 1:House Speaker Paul Ryan announced he will leave Congress at the end of his current term.As elder advocates, we believe this means Congress will lose its single strongest proponent of converting Medicare into a voucher program known as “premium support,” which aims to reduce the growth in Medicare spending and could end Medicare’s guaranteed benefits. Congress will also lose a key leader in attempts to take away The Affordable Care Act’s benefits to Medicare enrollees.

Medicare Advantage plans, an alternative to original Medicare, are the increasingly popular plans provided through private health insurers and include Medicare Part A coverage (hospital and catastrophic care) and Part B coverage (doctors’ visits and routine medical care.) They also can encompass prescription drug coverage, vision and dental insurance. Currently, 19 million Americans — one in three Medicare beneficiaries — have Medicare Advantage plans; enrollment grew by about 1.4 million between 2016 and 2017.

No. 3. The Centers for Medicare and Medicaid Services (CMS) recently announced that it will be expanding the definition of “health-related” supplemental benefits in Medicare Advantage plans to include “additional services that increase health and improve quality of life.” These would include benefits that “compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.”

This expansion is a huge move, and many advocates were in favor of it.

For the first time, Medicare Advantage plans will be able to offer services such as home modifications, home-delivered and medically-tailored meals (currently limited to a very small number of conditions) or aides to help with activities of daily living.

Such services will be crucial in allowing Medicare beneficiaries to stay in their homes as they age as opposed to requiring institutional care — which could ultimately drive down costs for Medicare and Medicaid overall. They will also certainly increase beneficiary satisfaction, particularly among the younger Medicare population who have higher expectations from their Medicare Advantage plans. Medicare Advantage plans have a slightly higher percentage of enrollees in the 65 to 84 age group: 77 percent, compared to 71 percent for original Medicare.